‘It could blow up into a big outbreak. Or it could settle along at this level and drop again.’

August 24, 2023
Purple gloved hands hold a tube with liquid in it.
Pouring samples into machine specific tubes for COVID tests. Photo by Sarah Pack

COVID-19 hospitalizations are climbing as scientists study a troubling new variant, BA.2.86. While the Centers for Disease Control and Prevention said in its latest risk assessment that BA.2.86 is not likely to be the cause of the national increase in hospitalizations, it also said it may revise that as more data come in.

Whatever the reason for the uptick, the impact is being felt in the Charleston Tri-county area. Michael Sweat, Ph.D., leads the COVID tracking team at the Medical University of South Carolina. “I think in the few weeks ahead, we'll really know. It could blow up into a big outbreak. Or it could settle along at this level and drop again.”

Either way, he said now is the time to start paying attention. COVID hospitalizations in the Charleston area are up 43% from last week. “It’s not a big number – something like 30 to 36 people right now admitted to the hospital with COVID in the Tri-county area. But the numbers are increasing for sure.”

His team recommends that people at high risk of getting severely ill from COVID should talk to a doctor about whether to wear a mask and take other precautions. That includes older people, people with chronic health problems and people with weakened immune systems.

“We're not in crisis territory like we were. I mean, this is not like an Omicron wave or anything, but COVID is definitely coming back. I think it's just what we have to get used to every year in the fall. We're likely to see these waves.”

The new variant, BA.2.86

While the CDC has only reported about 10 cases of BA.2.86 so far, Sweat called it a concern. “This variant is as genetically different as Omicron was from the original one. It has a dramatic number of mutations, particularly on the spike protein where it attaches. And some of the early lab studies are suggesting that those mutations evade immunity.”

Where did those mutations come from? Sweat said COVID probably infected someone who was immunocompromised and/or couldn’t clear the infection and had it for a long time. “So within their own body, it just mutated like crazy. And that led to this variant, which then got out.”

It got out – and around. It’s been documented in Denmark, South Africa, Israel, the United States and the United Kingdom.

Dr. Michael Sweat 
Dr. Michael Sweat

“When they analyze the genetics of each of those cases, they're all the same. As time passes, the virus will mutate. But the fact that this variant hadn't mutated any more suggests that it's been transmitting very quickly all over the place,” Sweat said.

The CDC is keeping close watch. In its Aug. 23 risk assessment of BA.2.86, it made the following statements:

“BA.2.86 may be more capable of causing infection in people who have previously had COVID-19 or who have received COVID-19 vaccines. Scientists are evaluating the effectiveness of the forthcoming, updated COVID-19 vaccine. 

“CDC’s current assessment is that this updated vaccine will be effective at reducing severe disease and hospitalization. At this point, there is no evidence that this variant is causing more severe illness. That assessment may change as additional scientific data are developed. CDC will share more as we know more.”

Sweat, a former research scientist with the CDC and a current professor in the MUSC College of Medicine and adjunct professor at the Johns Hopkins Bloomberg School of Public Health, said the variant already tells scientists and the public something important. 

“It's a signal that as we go into the future, you're going to see these weird variants popping up. That suggests we have the potential for other big waves in the future that will evade our immunity.”

He encouraged people to get the updated COVID vaccines that could be available as early as the middle of next month. Scientists may know more about BA.2.86 by then, including having a better idea of how well the updated vaccine works against it.

“BA.2.86 is scary and being watched. There are a lot of signals that it's not a great thing. Or it may just peter out. But it does tell you that we went a long time without a big variant change, and suddenly we see one. COVIDis not the mortal threat for most people that it was early in the pandemic. But you can't take that too far. You need still need to take it seriously.”

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